Journal of dentistry · 2025
Occurrence and predictors of severe pain one week after root canal treatment: the national dental PBRN PREDICT endodontic study.
СтатьяПоддержка исследования: вне правительства СШАПоддержка NIH: внешняя программаНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Mungia R, Funkhouser E, LawAS, Nixdorf D R, Diogenes A, Kopycka-Kedzierawski D T, Caprio D S, Gilbert G H, National Dental PBRN Collaborative Group
Аннотация
OBJECTIVE: Root canal treatment (RCT) is effective at relieving dental pain for most patients, but a minority report severe pain during the early post-treatment period. This study aimed to quantify the occurrence of severe pain during the 1-week period after RCT among consecutive patients requiring RCT and to identify pre-operative and intra-operative predictors of post-RCT severe pain in the National Dental Practice-Based Research Network.
METHODS: This prospective cohort study enrolled patients across 153 general and endodontic practices. Eligible adults undergoing RCT completed surveys before and 1 week after treatment. Severe post-RCT pain was defined as patient-reported worst pain ≥7 on a 0-10 scale in the prior 7 days. Demographic, clinical, procedural, and psychosocial characteristics were collected and analyzed using logistic regression with generalized estimating equations, accounting for clustering by practice.
RESULTS: Among 1,059 patients, mean worst pain scores declined significantly from 5.3 pre-RCT to 2.6 post-RCT (p<.001). However, 14% reported severe pain at 1 week. Female sex, severe pain at time of RCT, screening positive for temporomandibular disorders, diagnosis of fibromyalgia, and having taken pain medication for tooth pain in the 7 days prior to RCT, were each significantly associated with severe post-RCT pain. Neither age, tooth type, provider specialty status, or psychosocial characteristics were independently predictive. Presence of a draining sinus tract and use of over 5x magnification were protective.
CONCLUSION: One in seven patients reported severe pain in the first week after RCT, primarily associated with pre-operative pain factors and patient sex, underscoring the value of targeted pain management for high-risk patients.
CLINICAL SIGNIFICANCE: Despite overall pain reduction after RCT, 14% of patients experience severe pain at one week. Female sex, pre-existing pain, and certain comorbidities increase risk. Identifying these factors enables clinicians to implement anticipatory guidance and tailored pain management, improving outcomes and minimizing patient distress in vulnerable subgroups.
METHODS: This prospective cohort study enrolled patients across 153 general and endodontic practices. Eligible adults undergoing RCT completed surveys before and 1 week after treatment. Severe post-RCT pain was defined as patient-reported worst pain ≥7 on a 0-10 scale in the prior 7 days. Demographic, clinical, procedural, and psychosocial characteristics were collected and analyzed using logistic regression with generalized estimating equations, accounting for clustering by practice.
RESULTS: Among 1,059 patients, mean worst pain scores declined significantly from 5.3 pre-RCT to 2.6 post-RCT (p<.001). However, 14% reported severe pain at 1 week. Female sex, severe pain at time of RCT, screening positive for temporomandibular disorders, diagnosis of fibromyalgia, and having taken pain medication for tooth pain in the 7 days prior to RCT, were each significantly associated with severe post-RCT pain. Neither age, tooth type, provider specialty status, or psychosocial characteristics were independently predictive. Presence of a draining sinus tract and use of over 5x magnification were protective.
CONCLUSION: One in seven patients reported severe pain in the first week after RCT, primarily associated with pre-operative pain factors and patient sex, underscoring the value of targeted pain management for high-risk patients.
CLINICAL SIGNIFICANCE: Despite overall pain reduction after RCT, 14% of patients experience severe pain at one week. Female sex, pre-existing pain, and certain comorbidities increase risk. Identifying these factors enables clinicians to implement anticipatory guidance and tailored pain management, improving outcomes and minimizing patient distress in vulnerable subgroups.